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Terapevticheskii Arkhiv Jan 2022Paraprotein is a laboratory biomarker of plasma cell tumors and other lymphoproliferative diseases. Its determination is necessary for diagnosing, monitoring and...
Paraprotein is a laboratory biomarker of plasma cell tumors and other lymphoproliferative diseases. Its determination is necessary for diagnosing, monitoring and assessment of therapy effectiveness. The lecture presents the main methods of qualitative and quantative analysis of monoclonal proteins: gel electrophoresis, capillary electrophoresis, immunofixation and nephelometry features, possibilities and limitations are reviewed. The main sources of errors and artifacts during these studies are considered. Also the difficulties in the diagnosis and interpretation of the results of serum and urine tests are highlighted.
Topics: Humans; Paraproteins; Plasmacytoma; Multiple Myeloma; Immunoelectrophoresis; Blood Protein Electrophoresis
PubMed: 36286929
DOI: 10.26442/00403660.2022.01.201326 -
International Journal of Radiation... Mar 2020The study evaluates the results of the concurrent use of lenalidomide-dexamethasone with intensity modulated radiation therapy (IMRT) for solitary plasmacytoma in terms...
PURPOSE
The study evaluates the results of the concurrent use of lenalidomide-dexamethasone with intensity modulated radiation therapy (IMRT) for solitary plasmacytoma in terms of toxicity and outcome.
METHODS AND MATERIALS
Forty-six patients were treated for histologically proven solitary plasmacytoma (SP) between June 2007 and June 2018 in our Department (Curie Institute, Paris, France). All patients received IMRT. The median total dose was 40 Gy (range, 40-46). Prescription of concurrent lenalidomide-dexamethasone with radiation therapy was left to the discretion of the referring hematologist-oncologist and started the first day of radiation therapy for 4 cycles.
RESULTS
Twenty-seven solitary plasmacytoma were treated with IMRT alone and 19 with lenalidomide-dexamethasone in association with IMRT. At 5 years, the local control, multiple myeloma-free survival (MMFS), and progression-free survival (PFS) rates were 96.3%, 85.4%, and 60%. MMFS and PFS were significantly higher in the IMRT plus lenalidomide-dexamethasone group compared with IMRT alone group (100% vs 77.1%, P = .02 and 81.7% vs 48.4%, P = .047, respectively). No major toxicity was found in either group.
CONCLUSIONS
Lenalidomide-dexamethasone in association with IMRT in the treatment of solitary plasmacytoma is safe and improves MMFS and PFS. Further prospective and comparative studies are needed to confirm these results.
Topics: Adult; Aged; Antineoplastic Agents; Chemoradiotherapy; Dexamethasone; Disease-Free Survival; Drug Therapy, Combination; Female; Humans; Lenalidomide; Male; Middle Aged; Multiple Myeloma; Plasmacytoma; Progression-Free Survival; Radiotherapy, Intensity-Modulated; Survival Rate
PubMed: 31707123
DOI: 10.1016/j.ijrobp.2019.10.043 -
Clinical Nuclear Medicine Jun 2024A 56-year-old man with thoracal mass suspected of solitary plasmacytoma was referred for 18 F-FDG PET-CT scan. His PET-CT revealed FDG-avid rib mass and cervical lesion...
A 56-year-old man with thoracal mass suspected of solitary plasmacytoma was referred for 18 F-FDG PET-CT scan. His PET-CT revealed FDG-avid rib mass and cervical lesion at level 2. He also underwent 18 F-fluorocholine (FCH) PET-CT to evaluate possible metastatic spread of the disease. FCH PET-CT showed increased uptake at the rib mass, while the cervical lesion was not FCH-avid. Biopsies confirmed rib lesion was a solitary plasmacytoma; however, the cervical lesion was an amyloid deposited lymph node. This case showed FCH PET-CT is a valuable companion of FDG scan for the evaluation of plasma cell dyscrasias with a better specificity.
Topics: Humans; Male; Middle Aged; Plasmacytoma; Fluorodeoxyglucose F18; Positron Emission Tomography Computed Tomography; Choline; Lymphadenopathy; Amyloid
PubMed: 38557413
DOI: 10.1097/RLU.0000000000005210 -
Current Oncology (Toronto, Ont.) Aug 2022(1) Background: Plasma cell neoplasia can be separated into independent subtypes including multiple myeloma (MM) and solitary plasmacytoma of the bone (SBP). The first...
(1) Background: Plasma cell neoplasia can be separated into independent subtypes including multiple myeloma (MM) and solitary plasmacytoma of the bone (SBP). The first clinical signs patients present with are skeletal pain, most commonly involving ribs and vertebrae. (2) Methods: Retrospective analysis of 114 patients (38 female, 76 male) receiving spinal surgery from March 2006 until April 2020. Neurological impairments and surgical instability were the criteria for intervention in this cohort. Analysis was based on demographic data, Spinal Instability Neoplastic Score (SINS), location of the lesion, spinal levels of tumor involvement, surgical treatment, histopathological workup, adjuvant therapy, functional outcome, and overall survival (OS). (3) Results: The following surgical procedures were performed: posterior stabilization only in 9 patients, posterior stabilization and decompression without vertebral body replacement in 56 patients, tumor debulking and decompression only in 8 patients, anterior approach in combined approach without vertebral body replacement and without biopsy and/or without kyphoplasty in 33 patients, 3 patients received biopsies only, and 5 patients received kyphoplasty only. The histopathology diagnoses were MM in 94 cases and SBP in 20 cases. Median OS was 72 months (53.4-90.6 months). Preoperative KPSS was 80% (range 40-100%), the postoperative KPSS was 80% (range 50-100%). (4) Conclusions: Surgery for patients with plasma cell neoplasia is beneficial in case of neurological impairment and spinal instability. Moreover, we were able to show that patients with MM and a low number of spinal levels to be supplied have a better prognosis as well as a younger age at the time of the surgical intervention.
Topics: Female; Humans; Male; Multiple Myeloma; Plasma Cells; Plasmacytoma; Retrospective Studies; Spinal Neoplasms; Spine; Treatment Outcome
PubMed: 36135059
DOI: 10.3390/curroncol29090490 -
African Journal of Thoracic and... 2022Plasmacytoma is a plasma cell dyscrasia originating from a single clone of plasma cells of B-lymphocyte lineage and produces a monoclonal immunoglobulin. Transthoracic...
BACKGROUND
Plasmacytoma is a plasma cell dyscrasia originating from a single clone of plasma cells of B-lymphocyte lineage and produces a monoclonal immunoglobulin. Transthoracic fine-needle aspiration (TTNA) under ultrasound (US) guidance is a well-validated technique for the diagnosis of many neoplasms and has been shown to be safe and cost effective, with diagnostic yields comparable to more invasive techniques. However, the role of TTNA in the diagnosis of thoracic plasmacytoma is not well established.
OBJECTIVES
The aim of this study was to assess the utility of TTNA and cytology in confirming a diagnosis of plasmacytoma.
METHODS
All cases of plasmacytoma diagnosed from January 2006 to December 2017 by the Division of Pulmonology, Tygerberg Hospital, were retrospectively identified. All patients who underwent an US-guided TTNA and of whose clinical records could be retrieved were included in this cohort. The International Myeloma Working Group's definition of a plasmacytoma was used as the gold standard.
RESULTS
A total of 12 cases of plasmacytoma were identified and 11 patients included (one patient was excluded owing to missing medical records). Six of the 11 patients (mean age 59.5 ± 8.5 years) were male. Radiologically, most had multiple lesions (n=7), most commonly bony (n=6) with vertebral body involvement (n=5) and pleural-based lesions (n=2). Rapid onsite evaluation (ROSE) was performed and documented in 6 of the 11 cases, and a provisional diagnosis of plasmacytoma was suggested in 5 of the 6 patients (83.3%). The final laboratory cytological diagnoses of all 11 cases were compatible with plasmacytoma which was further confirmed via a bone marrow biopsy (n=4) and by serum electrophoresis (n=7).
CONCLUSION
US-guided fine-needle aspiration is feasible and is useful to confirm a diagnosis of plasmacytoma. Its minimally invasive nature may be the ideal investigation of choice in suspected cases.
PubMed: 36844937
DOI: 10.7196/AJTCCM.2022.v28i4.242 -
Journal of Medical Imaging and... Feb 2020Extramedullary plasmacytomas are rare and can occur at any site. The imaging results are often nonspecific. This report highlights the radiographic, sonographic and...
Extramedullary plasmacytomas are rare and can occur at any site. The imaging results are often nonspecific. This report highlights the radiographic, sonographic and cross-sectional imaging features of extramedullary plasmacytomas.
Topics: Adult; Aged; Aged, 80 and over; Diagnostic Imaging; Female; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Plasmacytoma; Radiography; Retrospective Studies; Tomography, X-Ray Computed; Ultrasonography
PubMed: 31785037
DOI: 10.1111/1754-9485.12975 -
Internal Medicine (Tokyo, Japan) Sep 2023
Topics: Humans; Plasmacytoma; Gallbladder Neoplasms; Multiple Myeloma
PubMed: 36517034
DOI: 10.2169/internalmedicine.1079-22 -
American Journal of Ophthalmology Case... Jun 2022Describe a case of intraocular plasmacytoma in a patient with multiple myeloma successfully treated with photon irradiation.
PURPOSE
Describe a case of intraocular plasmacytoma in a patient with multiple myeloma successfully treated with photon irradiation.
OBSERVATIONS
A 61-year-old man with a history of relapsing/refractory multiple myeloma and left frontal bone plasmacytoma treated with monthly belantamab mafodotin salvage chemotherapy developed bilateral treatment-related corneal keratopathy. An iris mass was incidentally noted in the right eye during a follow-up examination. The mass was amelanotic with diffuse intrinsic vasculature involving the pupillary margin from 1:30 to 10:30. Fundus examination showed an irregularly shaped amelanotic superotemporal scleral lesion in the right eye and two smaller amelanotic scleral lesions in the left eye. Given known systemic multiple myeloma and history of left frontal bone plasmacytoma, a presumed diagnosis of iris and scleral plasmacytoma was made. Due to rapid progression of the iris plasmacytoma despite systemic chemotherapy, the patient was treated with 20 Gy photon irradiation to the anterior and posterior segments of both eyes. One month after photon irradiation, there was complete regression of the iris plasmacytoma, and the scleral lesions in both eyes also appeared to be regressing despite systemic progression of multiple myeloma.
CONCLUSIONS AND IMPORTANCE
Intraocular plasmacytoma is rare and can occur in isolation but typically occurs as a manifestation of systemic multiple myeloma. Intraocular plasmacytoma can be successfully treated with photon irradiation in patients with multiple myeloma who progress on systemic chemotherapy.
PubMed: 35479520
DOI: 10.1016/j.ajoc.2022.101533 -
Zhonghua Xue Ye Xue Za Zhi = Zhonghua... Jan 2024Extramedullary plasmacytoma (EMP) is a special type of malignant plasmacytosis, which is complex and heterogeneous. Most EMP patients have poor prognosis and lack a...
Extramedullary plasmacytoma (EMP) is a special type of malignant plasmacytosis, which is complex and heterogeneous. Most EMP patients have poor prognosis and lack a stratified prognostic system or ideal treatment strategy supported by evidence-based medical evidence, which cannot meet clinical needs. In order to improve the understanding of this disease entity, Plasma Cell Disease Group, Chinese Society of Hematology, Chinese Medical Association and Chinese Myeloma Committee-Chinese Hematology Association developed the "Chinese Expert Consensus on the diagnosis and treatment of extramedullary plasmacytoma", which aims to standardize the clinical diagnosis and treatment of EMP and ultimately improve the overall survival of patients with plasmacytoma.
Topics: Humans; Plasmacytoma; Consensus; Multiple Myeloma; Prognosis; Paraproteinemias
PubMed: 38527832
DOI: 10.3760/cma.j.cn121090-20231107-00253 -
Veterinary and Comparative Oncology Jun 2023A total of 45 cases of canine oral extramedullary plasmacytomas (EMPs) presented to a tertiary referral institution over a 15-year period were examined. Histologic...
A total of 45 cases of canine oral extramedullary plasmacytomas (EMPs) presented to a tertiary referral institution over a 15-year period were examined. Histologic sections of 33 of these cases were examined for histopathologic prognostic indicators. Patients underwent variable treatment including surgical intervention, chemotherapy and/or radiation therapy. Long term survival was observed in the majority of dogs with a median survival time of 973 days (2-4315 days). However, almost 1/3 of dogs had progression of plasma cell disease, including two cases with myeloma-like progression. Histologic characterization of these tumours did not reveal criteria to predict tumour malignancy. However, cases without tumour progression did not exceed 28 mitotic figures in ten 400× fields (2.37 mm ). All cases with tumour related death showed at least moderate nuclear atypia. Oral EMPs may represent a local manifestation of systemic plasma cell disease or singular focal neoplasia.
Topics: Dogs; Animals; Plasmacytoma; Retrospective Studies; Dog Diseases; Multiple Myeloma; Prognosis
PubMed: 36808816
DOI: 10.1111/vco.12888